Distinct subcortical connectivity patterns of opioid and stimulant use disorders: A resting-state fMRI study

This study investigated resting-state functional connectivity (rsFC) patterns in individuals with opioid use disorder (OUD), stimulant use disorder (StUD) and healthy controls (HC). Using seed-based analysis of key subcortical regions, we found distinct connectivity profiles associated with each substance type. OUD showed reduced connectivity between limbic/basal ganglia structures and sensorimotor regions, along with increased pallidum-angular gyrus connectivity compared to HC. StUD exhibited decreased striatal-default mode network and limbic-prefrontal connectivity relative to HC. Direct comparison between OUD and StUD revealed widespread corticostriatal, striato-cerebellar, and prefrontal-limbic hyperconnectivity in OUD compared to StUD. These substance-specific alterations in intrinsic brain organization may reflect differential neuroadaptations underlying the cognitive and behavioral manifestations of opioid versus stimulant use disorders. Our findings highlight the potential of rsFC patterns as a biomarker for distinguishing among different subtypes of addiction and informing targeted interventions.